Augmented Reality-Assisted Craniotomy for Parasagittal and Convexity En Plaque Meningiomas and Custom-Made Cranio-Plasty: A Preliminary Laboratory Report

Nicola Montemurro, Sara Condino, Nadia Cattari, Renzo D’Amato, Vincenzo Ferrari and Fabrizio Cutolo
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Nicola Montemurro: Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana (AOUP), University of Pisa, 56100 Pisa, Italy
Sara Condino: Department of Information Engineering, University of Pisa, 56100 Pisa, Italy
Nadia Cattari: EndoCAS Center for Computer-Assisted Surgery, 56100 Pisa, Italy
Renzo D’Amato: Department of Information Engineering, University of Pisa, 56100 Pisa, Italy
Vincenzo Ferrari: Department of Information Engineering, University of Pisa, 56100 Pisa, Italy
Fabrizio Cutolo: Department of Information Engineering, University of Pisa, 56100 Pisa, Italy

IJERPH, 2021, vol. 18, issue 19, 1-13

Abstract: Background: This report discusses the utility of a wearable augmented reality platform in neurosurgery for parasagittal and convexity en plaque meningiomas with bone flap removal and custom-made cranioplasty. Methods: A real patient with en plaque cranial vault meningioma with diffuse and extensive dural involvement, extracranial extension into the calvarium, and homogeneous contrast enhancement on gadolinium-enhanced T1-weighted MRI, was selected for this case study. A patient-specific manikin was designed starting with the segmentation of the patient’s preoperative MRI images to simulate a craniotomy procedure. Surgical planning was performed according to the segmented anatomy, and customized bone flaps were designed accordingly. During the surgical simulation stage, the VOSTARS head-mounted display was used to accurately display the planned craniotomy trajectory over the manikin skull. The precision of the craniotomy was assessed based on the evaluation of previously prepared custom-made bone flaps. Results: A bone flap with a radius 0.5 mm smaller than the radius of an ideal craniotomy fitted perfectly over the performed craniotomy, demonstrating an error of less than ±1 mm in the task execution. The results of this laboratory-based experiment suggest that the proposed augmented reality platform helps in simulating convexity en plaque meningioma resection and custom-made cranioplasty, as carefully planned in the preoperative phase. Conclusions: Augmented reality head-mounted displays have the potential to be a useful adjunct in tumor surgical resection, cranial vault lesion craniotomy and also skull base surgery, but more study with large series is needed.

Keywords: augmented reality; craniotomy; meningioma; surgical planning; laboratory; brain tumor (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3)

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